IBS and Parkinson's

I have had IBS with constipation for several years, with chronic RUQ pain. My family doctor started me on Amitiza 8 mcg two times a day about a year ago. It has worked fairly well. He also put me on an IBS diet, which only allows soluble fiber. I mostly eat oatmeal for fiber now. On this diet I can't have fat or dairy products, so I don't eat potatoes anymore because they are unpalatable without butter and sour cream. Are sweet potatoes a good substitute? I eat baked sweet potato fries. Can you suggest any other sources of soluble fiber?Now that I know I have Parkinson's, I wonder if my constipation could have been an early sign of Parkinson's.

I am not a human being trying to have a spiritual experience; I am a spiritual being having a (sometimes difficult) human experience.

First symptoms: right-hand tremor, constipation and restless arms 1978 (age 25). Depression and anxiety (non-motor symptoms) began in 1989 and worsened through the years. Last inpatient episode June 2013.

Diagnosed December, 2010 by a regular neurologist (age 57). After negative reactions to Requip, Mirapex and selegiline began Sinemet 25/100 3x/day. First MDS visit in Houston in February of 2011 was inconclusive. Second MDS visit at Baylor Fort Worth in May/June 2011 diagnosis changed to Parkinsonism, Sinemet stopped. Third MDS visit in August 2011 in WA State: received a confirmed diagnosis of idiopathic PD which had started on the right side and had now crossed to the left side as well. Restarted on Sinemet 25/100 4x/day. A short trial of Amantadine caused audio hallucinations in September 2011.

Good thinking on your part – constipation is frequently one of the earliest signs of PD, and there certainly could be a link. Amitiza is generally prescribed for chronic idiopathic constipation, and for IBS with constipation. You may well have IBS, with constipation exacerbated by PD.

It’s good the Amitiza is working for you; but I’m concerned about the prohibited use of dairy and fats. I am concerned that you might not be getting sufficient calcium and vitamin D, nor beneficial fatty acids.

Have you considered asking for a referral to a gastroenterologist? Such a specialist might want to rule out allergies to foods and food additives, which are known to be a factor in some cases of IBS; also small intestinal bacterial overgrowth. S/he might also want to trial use of probiotics, which have proved useful for many people (*I post a journal article reference below), or enteric coated peppermint oil. This, along with a visit with a registered dietitian, might result in a more focused and beneficial diet – one that contains moderate amounts of beneficial fats. Omega-3 fatty acids are critically important for the health of the brain and nervous system, important for those with PD.

Meantime, some sources of soluble fiber include barley, nuts, seeds, lentils, citrus fruits, apples, strawberries, and carrot, as well as psyllium and flax seed. A 3.5 ounce serving of baked sweet potato with skin contains about 2 ½ grams of insoluble fiber, and about 1.7 grams of soluble fiber. If sweet potatoes are not causing you any problem, it should be fine to continue eating them.

Summary: In a randomized, placebo-controlled, double-blind study involving 52 subjects with irritable bowel syndrome (IBS), supplementation with a multistrain probiotic preparation (LAB4), comprised of 2 strains of Lactobacillus acidophilus CUL60 (NCIMB 30157) and CUL21 (NCIMB 30156), Bifidobacterium lactis CUL34 (NCIMB 30172) and Bifidobacterium bifidum CUL20 (NCIMB 30153), at a total of 2.5 x 10(10) cfu per capsule for a period of 8 weeks, was found to significantly reduce the severity of IBS symptoms and days with pain, and significantly improve quality of life and satisfaction with bowel habits. These results suggest that supplementation with a multistrain probiotic preparation, such as that used in this study, may be of benefit to patients with IBS.